Ruxolitinib is an effective salvage treatment for multidrug-resistant graft-versus-host disease after haploidentical all
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ORIGINAL ARTICLE
Ruxolitinib is an effective salvage treatment for multidrug-resistant graft-versus-host disease after haploidentical allogeneic hematopoietic stem cell transplantation without posttransplant cyclophosphamide Jiao-Yu Zhao 1,2 & Si-Ning Liu 1 & Lan-Ping Xu 1,3 & Xiao-Hui Zhang 1 & Yu Wang 1 & Yu-Hong Chen 1 & Kai-Yan Liu 1 & Xiao-Jun Huang 1,3,4 & Xiao-Dong Mo 1,3 Received: 27 November 2019 / Accepted: 4 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The purpose of our study is to identify the efficacy of ruxolitinib in human leukocyte antigen (HLA) haploidentical hematopoietic stem cell transplantation (haplo-HSCT) recipients with multidrug-resistant (MDR)-graft-versus-host disease (GVHD, n = 34). MDR-GVHD was defined as GVHD showing no improvement after at least 3 types of treatments. The median number of previous GVHD-therapies was 4 for both MDR-acute GVHD (aGVHD) and MDR-chronic GVHD (cGVHD). For MDRaGVHD (n = 15), the median time to response was 10 days (range 2 to 65), and the overall response rate (ORR) was 60.0% (9/15), including 40.0% (6/15) complete response (CR) and 20.0% (3/15) partial response (PR). The 1-year probability of overall survival after ruxolitinib was 66.7%. The rates of hematologic and infectious toxicities were 73.3% and 46.7% after ruxolitinib treatment. For MDR-cGVHD (n = 19), the median time to response was 29 days (range 6 to 175), and the ORR was 89.5% (17/ 19), including 26.3% (5/19) CR and 63.2% (12/19) PR. All patients remained alive until our last follow-up. The rates of hematologic and infectious toxicities were 36.8% and 47.4% after ruxolitinib treatment. Ruxolitinib is an effective salvage treatment for MDR-GVHD in haplo-HSCT recipients. Key words Ruxolitinib . Multidrug-resistant . Graft-versus-host disease . Hematopoietic stemcelltransplantation . Haploidentical
Introdution Jiao-Yu Zhao and Si-Ning Liu contributed equally to this work. Supplementary Information The online version of this article (https:// doi.org/10.1007/s00277-020-04273-2) contains supplementary material, which is available to authorized users. * Xiao-Dong Mo [email protected] 1
Peking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
2
Department of Hematology, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China
3
Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing 2019RU029, China
4
Peking-Tsinghua Center for Life Sciences, Beijing 100044, China
Allogeneic hematopoietic stem cell transplantation (alloHSCT) is the most effective treatment for hematological malignancies, and human leukocyte antigen (HLA)haploidentical–related donors (haplo-RDs) have already become one of the most important alternative donors for alloHSCT [1]. Although we used granulocyte colony-stimulating factor (G-CSF) and
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